GAO: Patient access to medical records remains a challenge

Despite the widespread adoption of electronic health records by providers, patients continue to face challenges in accessing their healthcare information, according to a new audit by the Government Accountability Office.

Under HIPAA, consumers have the right to inspect, review and receive a copy of their medical records, while providers are authorized to charge a reasonable cost-based fee when patients request copies of their medical records or request that their records be forwarded to another provider or entity, such as an insurer or lawyer.

However, according to the GAO, the fees for third-party requests are generally higher than the fees charged to patients—which can vary significantly across states—while high fees can adversely affect patients’ access to their medical records.

“Patients’ challenges include incurring what they believe to be high fees when requesting medical records—for example, when facing severe medical issues that have generated a high number of medical records,” found the auditors. “Additionally, not all patients are aware that they have a right to challenge providers who deny them access to their medical records.”

“Providers’ challenges include the costs of responding to patient requests for records due to the allocation of staff time and other resources,” states the report. “In addition, according to provider associations and others GAO interviewed, fulfilling requests for medical records has become more complex and challenging for providers, in part because providers may store this information in multiple electronic record systems or in a mix of paper and electronic records.”

Auditors noted that widespread adoption of EHRs by providers has resulted in a more complex and challenging environment when responding to requests for patients’ medical records. They found that extracting records from EHRs is not a simple “push of a button” process but often requires providers—or their vendors—to go through multiple systems to compile the requested information. In addition, printing a complete record from an EHR can generate a document that is hundreds of pages long.

Another challenge confronting providers that have transitioned from using paper records to EHRs is that information has been scanned into electronic formats that have “resulted in records being incorrectly merged (e.g., the records of two patients merged into a single record)” and as a result, “when responding to a medical record request, providers or their vendors must carefully go through each page of the record to ensure only the correct patient’s medical records are being released,” states the GAO.

Making matters worse, providers “often have multiple active EHR systems, or have legacy EHR systems in which some medical records are stored,” which “requires providers and their vendors to go through multiple EHR systems to extract information in response to a medical record request,” found the auditors. In addition, they reported that some providers still have a mix of paper records and EHRs, which makes responding to medical record requests more difficult and time consuming.